Spectrum of the Microorganisms in Children with Urinary Tract Infection

Background: To determine the spectrum of microorganisms and their sensitivities in children with urinary tract infection (UTI.) Methods: This study was conducted in Pediatrics department of Holy Family Hospital, Rawalpindi. 150 children between 1 – 12 years of age presenting with fever ≥ 101 °F with duration of 10 days or less without any definite focus of infection were included in the study. Children who already had received antibiotics in previous 48 hours or were comatose, immunocompromised or with congenital urinary tract abnormalities were excluded from the study. Results: Escherichia. coli and Klebsiella were the commonest uropathogens. Other uropathogens obtained were Proteus mirabilis, Enterobacter and Staphylococcus aureus. Maximum sensitivity was to co-amoxiclav, cephalosporins aminoglycosides and quinolones. Organisms showed maximum resistance to ampicillin, amoxicillin and nalidixic acid with low resistance to cephalosporins, quinolones and aminoglycosides. Conclusion: UTI is a common source of infection among children presenting with unexplained fever. Co-amoxiclav or cephalosporins can be started as an empirical agent that can be changed later according to the culture and sensitivity report

Comparison of Oral Azithromycin and Intra Venous Ceftriaxone for Treatment of Uncomplicated Enteric Fever in Children

Background : To compare the clinical efficacy of intravenous (I/V) Ceftriaxone with oral Azithromycin in 2-12 year old children diagnosed with enteric fever. Methods: In this comparative study children with the history of fever for >4 days and at least two out of these findings, i.e., toxic physical appearance, abdominal pain, coated tongue, hepatomegaly, splenomegaly were divided into two equal groups. Patients in Group A were given Azithromycin 20 mg / kg/ day as a single oral dose whereas patients in Group B were given Ceftriaxone 100 mg/kg/day as a single I/V injection for 07 days. Before initiation of therapy samples for Typhidot and Widal test were collected and only those testing positive were included. Results: There were 42 (93.3%) and 40 (88.9%) patients in both the groups respectively who were clinically cured. No significant difference was found between these two groups (p-value 0.459). Conclusion: There was no difference in the clinical efficacy between Ceftriaxone and Azithromycin for the treatment of typhoid fever in children

Targeted ultrasound of an indeterminate breast lesion on mammography: When does it influence management?

Objective: To determine the change over mammographic diagnosis, BI-RADS category and management following targeted ultrasound of an indeterminate lesion seen on mammography and associated factors, if any.Study design: Descriptive, analytical study.Place and duration of study: Radiology Department, The Aga Khan University Hospital and Clifton Medical Services, Karachi, from April 2010 to May 2011.Methodology: Patients referred for targeted breast ultrasound following X-ray mammography were selected regardless of age. Targeted Ultrasound (TUS) was defined as a limited ultrasound of a specific lesion or breast part as indicated by the referring source. Comparison was made between the post mammography and post TUS lesion characterization, diagnosis and BI-RADS category (0-5) which was taken as a measure of management change. Those were evaluated to determine significance of age, marital status, parity, breast parenchymal pattern ( dense, fatty, heterogeneous), referring source for the TUS (radiology resident, radiologist or surgeon), lesion characteristics (density, echogenecity, shape, location, margins, size, depth-to-width ratio, enhancement or shadowing), presenting symptoms or signs and reason for TUS. Ap-value of 0.05 or less was taken as significant.Results: There were a total of 342 patients with mean age of 49.7 ±13.5 years. It assigned a definite category in 232 patients with an indefinite category (0) on mammography requiring further investigation. It decreased the suspicion for malignancy in 180 (77.58%) by assigning a low BI-RADS category and increased the suspicion in 52 (22.41%). The factors significantly associated with this changes included clinical indication being diagnostic (p \u3c 0.001), lesion characteristics on imaging (p \u3c 0.001), heterogenous breast parenchymal pattern (p \u3c 0.001) and presence of known risk factors (p=0.049).Conclusion: TUS served as a problem solving tool in the evaluation and management of an indeterminate breast lesion in a high number of patients, particularly when there was a lump as indication for imaging in the presence of risk factors in a patient with otherwise heterogeneously dense breast parenchyma

Breastfeeding perception among Medical students of Islamic International Medical College (IIMC) in relation to COVID-19 pandemic

Background: Breastfeeding is crucial for the development & growth of the infant in the early years of life. Unfortunately, the incidence of breastfeeding is very low in our part of the world. Doctors play a critical role in the public awareness of the benefits & importance of breastfeeding. This study is done to find out the perception, knowledge and attitude of medical students about breastfeeding and its implications during COVID 19 pandemic. Methods: This cross-sectional study was conducted at Islamic International Medical College (IIMC) from 10 november 2021 to 30 november 2021. An online questionnaire was sent to the students of MBBS from first to final year via email. Results were analyzed on SPSS version 21. Results A total of 316 students participated. The majority of students were aware of the initiation, duration and advantages of breastfeeding. 88% of students answered that breast milk is an ideal food for a baby. 77.2% had the perception that breastfeeding increases mother-infant bonding. 71.51% of students answered that breastfed babies have fewer health-related issues compared to formula-fed babies. 40 % of students were of the idea that there is a risk of transmission of COVID 19 from mother to baby if breastfed fed while 42% believed that breastfeeding protects against COVID 19. Conclusion The majority of the students of IIMC were aware of benefits of breastfeeding but most of them lacked knowledge of breastfeeding by mothers suffering from COVID 19. The medical curriculum should have more emphasis on nutrition counselling for both mothers and children and information regarding breastfeeding particularly during situations like COVID 19 pandemic.   Keywords:  Breastfeeding, COVID 19, Medical Students

Breastfeeding perception among Medical students of Islamic International Medical College (IIMC) in relation to COVID-19 pandemic

Background: Breastfeeding is crucial for the development & growth of the infant in the early years of life. Unfortunately, the incidence of breastfeeding is very low in our part of the world. Doctors play a critical role in the public awareness of the benefits & importance of breastfeeding. This study is done to find out the perception, knowledge and attitude of medical students about breastfeeding and its implications during COVID 19 pandemic. Methods: This cross-sectional study was conducted at Islamic International Medical College (IIMC) from 10 november 2021 to 30 november 2021. An online questionnaire was sent to the students of MBBS from first to final year via email. Results were analyzed on SPSS version 21. Results A total of 316 students participated. The majority of students were aware of the initiation, duration and advantages of breastfeeding. 88% of students answered that breast milk is an ideal food for a baby. 77.2% had the perception that breastfeeding increases mother-infant bonding. 71.51% of students answered that breastfed babies have fewer health-related issues compared to formula-fed babies. 40 % of students were of the idea that there is a risk of transmission of COVID 19 from mother to baby if breastfed fed while 42% believed that breastfeeding protects against COVID 19. Conclusion The majority of the students of IIMC were aware of benefits of breastfeeding but most of them lacked knowledge of breastfeeding by mothers suffering from COVID 19. The medical curriculum should have more emphasis on nutrition counselling for both mothers and children and information regarding breastfeeding particularly during situations like COVID 19 pandemic.   Keywords:  Breastfeeding, COVID 19, Medical Students

To asses inter- and intra-observer variability for breast density and BIRADS assessment categories in mammographic reporting

Objective: To evaluate the inter- and intra-observer variability among radiologists in the characterisation of mammograms according to Breast Imaging Reporting and Data System assessment and breast density categories.Methods: The descriptive cross-sectional study was conducted at Aga Khan University Hospital, Karachi, from January 2014 to June 2014. Using non-probability purposive sampling, all mammograms in the study were interpreted by three radiologists on the basis of Breast Imaging Reporting and Data System categories and by assessing the breast density composition. The inter-observer variability was recorded by comparing the difference in the interpretation and categorisation of each case. Intra-observer variability was noted by comparing the differences in the two sets of results from reading the same mammogram three months apart.Results: A total of 254 mammograms were reviewed and the mean age of patients was 55.2±11.6 years. In the first round of diagnostic imaging, there was moderate agreement among all three possible pairs of observers regarding breast density (k= 0.50-0.41), but for Breast Imaging Reporting and Data System categories the agreement was less (k=0.27-0.13). After 3 months, variability of observer 1 showed substantial agreement (k=0.65).Variability between observer 2 and observer 3 showed moderate agreement (k=0.13).In terms of categories, intra-observer differences were variable: observer 1 (?=0.61; observer 2(?=0.17); observer 3 (k=0.45).Conclusions: Despite standardised guidelines for reporting density and assessment categories, observer variability continues to exist

Biological Activity and Characterization of Bioactive Compounds under Lead Induced Stress in Maize

Background: Lead is most commonly released environmental contaminant making its way to air, soils and water. It causes hormonal imbalance and over production of reactive oxygen in plants when absorbed through leaves and roots. It contaminates the ground water depending on the type of soils and characteristics of lead. Plants ability to tolerate lead is linked with cell wall potential, activation of antioxidants defense mechanism and synthesis of osmolytes.Methods: The study was designed to evaluate the effects of Pb(NO3)2 induced stress on biological activity and bioactive compounds in maize. The plants were subjected under two different lead concentrations (T1- 0.35mg/ml and T2- 0.45mg/ml). Phytochemical screening revealed the presence of alkaloids, coumarins, saponins, tannins and terpenoids in maize. Total Phenolic Content (TPC) was increased (T1- 45%, T2- 58.42%) under lead stress when compared with control (36.29%). The cytotoxicity was checked using hemolytic activity against human red blood cells.Results: The scavenging rate was highest (T1- 33.5%, T2- 52%) when compared with control (18.6%). Zone of inhibition of Aspergillus niger was highest amongst other fungal strains. The HPLC results showed that maize has some phyto-ingredients which may be accountable for cell reinforcement and anti-microbial activity. The extracts were further analyzed for the biochemical profile like superoxide dismutase, peroxidase, catalase, amylase and protease. Escherichia colishowed maximum activity with control (25±3.46mm) and maximum under stress (T1- 17±1.633 mm, T2- 20±4.08 mm).Conclusion: Lead stress altered all the activities when compared to control plants. In conclusion, Maize can be used as a potential indicator for lead and other compounds to play a vital role in phytoremediation. The results would further lead to find the new compounds and plant mechanism to cope with stress.